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10 Cards in this Set
- Front
- Back
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Factors that affect drug response
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Genetics
age diet drug-drug interactions organ function nature and severity of disease |
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Azathiopurine metabolistm
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Leukemia and anti-inflammatory drug.
Azathiopurine metab to 6-mercaptopurine and this is metab by TPMT enzyme. But in 1/300 there is no TPMT enzyme so toxic dose is easily achieved and BM gets wiped out. Heterozygotes have some toxicity. |
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2D6 genotypes
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Poor metabolizer - no functional allel
intermediate metabolizer - 1 functional allele Extensive - 2 ultra-rapid metabolizer - >2 copies of the gene. |
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Tamoxifen/Endoxifen
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Breast CA drug
Tamoxifen metabolized to endoxifen (the active drug) by CYP2D6. |
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Codeine and nursing mothers
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If mom is an ultra-rapid metabolizer (CYP2D6), her breast milk can contain v. high levels of morphine.
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Common drug classes metabolized for CYP2D6.
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Opiates, beta-blockers, anti-arrythmics, neuroleptics, antidepressants, tamoxifen.
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Ironotecan
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Topo 1 inhibitor.
Inidiv. homozygous for a certain allele (UGT1A1) can get really bad neutropenia after using this drug. |
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Warfarin dosing
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CYPs
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Drugs to avoid with G6PD deficiency
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Analgesics, anti-malarials, anti-bacterials
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Summary slide
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Genetics is a significant determinant of individual drug response
FDA-PGx testing for TPMT (azathioprine), CYP2D6 (Atomoxetine, morphine), UGT101*28 (Ironotecan), CYP2C9/VKORC1 (Warfarin) C21st pharmacotherapy will involve [PGx + clinical] |
